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Posts Tagged ‘Sexuality’

Five Reasons ‘HIV Undetectable’ Must Equal ‘Untransmittable’

Thursday, December 15th, 2016

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Image detail from AIDES France Révélation campaign about being undetectable.

 

“We are not dirty, we are not a threat, and we are not disease vectors. In fact, we are the solution. People living with HIV who achieve viral suppression, who become undetectable, are the solution to the end of new HIV infections in the United States… When we look back 20 years from now we’re going to judge ourselves in terms of how well we responded to this opportunity.”

Dr. Rich Wolitski, person living with HIV and Acting Director for the Office for HIV/AIDS and Infectious Disease Policy at the U.S. Department of Health and Human Services

 

When Dr. Wolitski delivered his speech at the closing plenary of the 2016 United States Conference on AIDS (USCA), he received a standing ovation. He was referring to this year’s newest findings of HPTN 052 and the PARTNER study, which showed that people living with HIV who are undetectable are not transmitting the virus to their negative partners.

How wonderful that something many of us have assumed for years has been proven to be true. So now we can spread the news and encourage people with HIV to seek treatment and stick with it. And hey, there’s nothing like a little intercourse a la natural with your partner to reward yourself for being undetectable, am I right?

Not so fast. There is some strong resistance to a message that equates undetectable to untransmittable, and it’s not coming from where you might think.

Here are five reasons why this breakthrough message matters.

1. The science is solid.

The PARTNER Study has recorded 58,000 acts of penetrative sex without condoms between 1,000 positive/negative couples, in which the HIV positive partner had an undetectable viral load. There were no infections between the couples. Not a single one. The same results were reported in the HPTN 052 study and the empirical evidence to date. As Dr. Wolitiski said in his USCA speech, “this is a game-changing moment in the history of the HIV epidemic.”

Resistance to the conclusion that undetectable people pose no risk of infection has been either a matter of scientific data scrutiny or a fear that people may not actually be undetectable when they think they are. Let’s break that down.

A review of the argument against saying “zero risk” is enough to make you cross-eyed. It is based on the premise that nothing, really, is without risk. Detractors of the non-infectious message will calmly explain the perils of placing any risk at zero and then hypnotize you with statistical origami. Suffice it to say that proving zero risk is statistically impossible. You risked electrocution by turning on your device to read this article.

There will always be somebody who claims a terminally unique HIV infection, even if the precise circumstances of their claim may be murky. Weird things happen. Some folks are convinced that people who drink alcohol sometimes spontaneously combust. But you don’t see warning labels about it slapped on every bottle of Wild Turkey by overzealous worrywarts.

And yes, there is the possibility that someone might develop a viral load if they are not adherent to treatment and then transmit the virus. But the message here is that people who are undetectable cannot transmit HIV. If you stay on treatment and are undetectable you will not transmit HIV. Can we please celebrate this simple fact without remote qualifiers?

It is also important to note that a Canadian consensus statement concluded that any “viral blips” or sexually transmitted infections (STIs) were “not significant” to HIV transmission when someone is undetectable.

2. Major health experts are on board (but not all community leaders).

Public health leaders, from the New York Department of Health to the National Institutes of Health (NIH), have embraced these findings and its meaning to people with HIV, while community advocates and organizations have been reluctant to get on board, citing a theoretical risk of infection. Or maybe they consider changing their fact sheets and web sites an enormous bother.

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Bruce Richman of Prevention Access Campaign. (Sean Black / Courtesy A&U Magazine)

The Prevention Action Campaign and their seminal message “U=U” (undetectable equals untransmittable) was founded on the energetic efforts of a man named Bruce Richman. He entered the HIV advocacy scene a few years ago, seemingly out of nowhere, carrying aloft the banner of undetectability. Richman gathered signatures of health experts the world over for a consensus statement about the research, while cajoling every U.S. HIV organization in sight to adopt language that removes the stigma of infectiousness from people who are undetectable.

My review of the web sites and statements from major HIV organizations includes no strong language about undetectable people not transmitting HIV. Worse, some exaggerate the risk from those who are undetectable. How could such a new research breakthrough be met with such ignorance and apathy by our own leaders? I will defer shaming anyone by name while they take a little time to update their official language. (Notable exceptions to this sad rule include work going on in the United Kingdom and France that flatly states that undetectable means non-infectious.)

This skepticism from our own community reduces people with HIV, again, to a problem that must be managed. It suggests that those of us who have achieved undetectability don’t have the judgment to keep taking our medications or to see our physician regularly to be sure our treatment plan is still effective. It keeps us in the role of untrustworthy victims unable to make decisions that will keep the rest of you safe from us. What infuriating, stigmatizing nonsense.

 

3. This is about HIV. Only HIV.

Auxiliary issues often creep into this debate that may be well-meaning but only muddy the waters, such as the fear that promoting the message of non-infectiousness will lead to more sexually transmitted infections (STIs) because of the freedom it allows (see also: critics of PrEP, the birth control pill, and any other vehicle that might lead to unbridled sexual pleasure).

Rates of STIs — which were on the rise before the advent of PrEP or news from the PARTNER Study — are deeply concerning but ultimately tangential. We are in desperate need of comprehensive sexual health programs, to be sure, but in this instance I feel compelled to “kill the alligator closest to the boat.” This is about being HIV undetectable, not syphilis impermeable. Being undetectable will not prevent other infections or address promiscuity or remove stubborn stains.

Advocates are also sensitive to the continued compartmentalization of our community, between those who are positive or not, who is on PrEP or not, and now, between those with HIV who are able to achieve viral suppression and those who cannot, despite their best efforts. I sympathize with this new divide among HIV positive people but believe the greater good – removing shame and stigma from those who are not capable of transmitting – shouldn’t be downplayed. All HIV positive people of good will can and should celebrate this development, regardless of their own viral load.

4. This is a major victory for HIV criminalization reform.

Terribly important work is being done to repeal and reform HIV criminalization laws that prosecute people with HIV for not disclosing their status to a sexual partner. Our defense is often led by all of this growing science showing that the defendant never posed a risk to their partner in the first place, due to their use of protection or the fact the defendant was undetectable and therefore rendered harmless.

Continued assertions that undetectable people might pose a risk to others could be used in the courtroom against people with HIV.  Imagine the glee with which prosecutors might explain to a jury that “zero risk” is impossible and defendant Joe Positive posed a threat, however small, to his sexual partner and should be jailed for it. Put obscure doubts into the heads of a jury, and another person with HIV gets a 30-year sentence for daring to have sex at all.

5. This profoundly changes how people with HIV view themselves.

Internalizing the fact that I cannot transmit HIV to anyone has had an effect on me that is difficult to describe. I can only liken it to the day the Supreme Court voted for marriage equality. Intellectually, I knew I was a gay man and a worthy human being. But on the day of the court’s decision I walked through the streets of my neighborhood with my head held higher. Something had changed. I felt whole.

In my thirty-five years living with HIV, I have never felt exactly that way. I deserve to. And so do millions of other people with HIV.

Of all the arguments to adopt the message that undetectable people cannot transmit HIV, that enhanced feeling of self-worth may be the most important reason of them all.

Mark

(And now, only days after the posting of this piece, Housing Works has become the first HIV organization in the U.S. to come out explicitly with a #UequalsU message. It is just the kind of leadership I have come to expect from Housing Works.)

ALSO…

holiday-spectacularHave you seen the My Fabulous Disease Holiday Spectacular? I love to share it each year, just like the Grinch and Charlie Brown television specials. Not only does this video blog have Santa and cookies and even a touch of drag, it introduces you to most of my family, who discuss candidly what it has been like to love someone living with HIV. You’ll laugh, you’ll cry, it’s like a warm visit home. Check it out on Youtube here.

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Posted in Gay Life, Living with HIV/AIDS, My Fabulous Disease, News, Prevention and Policy | 8 Comments »

New Short Film Unmasks Fear Behind HIV Criminalization

Thursday, December 8th, 2016

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The making of the new short documentary, HIV Criminalization: Masking Fear and Discrimination, began in exactly the right place: with people living with HIV themselves, and their personal stories of being prosecuted because of their HIV status.

Sean Strub, founder of The Sero Project, had taped interviews with nearly a dozen people from across the country who had been accused of violating State statutes about HIV disclosure. Some had served time. One of them is in jail, serving a sentence of thirty years.

It was my privilege to assist documentary filmmaker Christopher King (no relation) in creating this short film, with the interviews with people with HIV as a starting point. Masking Fear and Discrimination is an excellent primer on the issue. Please watch it.

 

HIV criminalization feels very much like unfinished business for me as an HIV advocate. How in the world can we turn our backs on those who face jail time because they live in a society in which they are so feared and stigmatized that they find it difficult to disclose their status to their partner? And if they pose no risk to their sexual partners – because they are not having risky sex, or are using protection, or are undetectable and therefore non-infectious – why are there laws commanding them to disclose their status anyway?

People often have a visceral reaction to this issue, and I get that. But the more people know about the way in which these laws are being applied – as a tool of racism and homophobia, and to prevent people with HIV from daring to have sex at all – then the more likely they are to support the repeal of these laws.

Watch the film. Decide for yourself. And please share your views.

Thanks for watching, and please be well.

Mark

Masking Fear and Discrimination was made possible through the support of the H. van Ameringen Foundation, Broadway Cares/Equity Fights AIDS, the Elton John AIDS Foundation, and the Gill Foundation.
The short film features Cecilia Chung, SERO’s board chair and senior strategist at the Transgender Law Center (San Francisco, CA), Venita Ray, attorney and advocate at Legacy Community Health Services (Houston, TX), Anthony Mills, MD (Los Angeles, CA), and Justin Rush, director of public policy at the True Colors Fund and formerly a manager of policy and legislative affairs at the National Alliance of State and Territorial AIDS Directors (Washington, DC).

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Posted in Gay Life, Living with HIV/AIDS, My Fabulous Disease, News, Prevention and Policy | 1 Comment »

The Compassionate Truce of Tim Murphy’s Novel ‘Christodora’

Monday, November 28th, 2016

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In the towering new novel Christodora, author Tim Murphy harnesses decades of personal and professional experience as an HIV journalist into a story that sweeps back and forth between the last several decades and beyond. It has the scope of great literature, but Christodora is also a deeply personal chronicle from a man who knows his terrain.

The book’s namesake is a century-old apartment building in New York City’s East Village, silently weathering the indignities of time, economics, and social change that is mirrored in a host of characters connected to the building through the years. They include a privileged young couple, both of them artists, their adopted child, revelers of the gay dance clubs in the village, social activists and fledgling health department professionals. Since the story takes root in the 1980s, we know our characters are poised to confront something they can never imagine.

Yes, there are AIDS horrors here, of the multitudes who die around the edges of the book’s pages. But Murphy’s lens is more interested in close-ups, in the intimate impact of calamity, in various forms, on the lives of his characters. He also writes with the distance and maturity to know that AIDS wasn’t the only crisis in town for New Yorkers during this period, and even within it, AIDS greedily intersected with numerous other social ills and personal struggles.

Author Tim Murphy (Edwin Pabon)

Author Tim Murphy (Edwin Pabon)

With hardly a false move, Murphy glides effortlessly among the worlds of addiction and recovery, the academic art scene, AIDS activism, and the darkened corners of mental illness.

It is a gift for any writer to find the interior voice of a character – the cyclical doubts and fears, the ongoing internal debates in which we all engage that propel our lives and choices – and so it is with Murphy, who has multiplied the feat by populating the novel with an astounding number of flesh-and-blood people who behave with all the faults and courageousness that humanity allows.

Murphy is coy about providing too many historical names and places. The inner workings of ACT UP and its more establishment-friendly offspring, Treatment Action Group, are dramatized at great length but the groups are never mentioned by name. It releases Murphy from the job of shackling his story to actual people and organizations; this is not historical autobiography in the vein of Sean Strub’s Body Counts or Cleve Jones’ upcoming When We Rise. The emerging AIDS activism scene is portrayed, Murphy has us feel, because some of his characters happen to be there. They come first.

That said, anyone familiar with the gay New York City scene from this era will enjoy the parlor game of spotting the real people who inspired several major characters. Some are transparent, others not. Christodora had me Googling the names and affiliations of my guesses more than once.

christodora-jacketThe most searing passages in Christodora deal with the wreckage of drugs and those engulfed by them, calibrated for maximum heartbreak. For any of us who turned to substance abuse during or after the plague years, who live with the confusion and guilt of having survived a public health emergency only to surrender ourselves to small baggies of crystalized catastrophe, Murphy knows us, and he intimately (and sometimes explicitly) offers us front row seats to the destruction of major characters. The brutality of addiction cannot be divorced from the story of AIDS.

Christodora even has the audacity to look beyond the present, providing glimpses into years we have not yet seen. Audacious, because Murphy knows there is no AIDS survivor among us who hasn’t considered what lies ahead, as the crisis years continue to fade from view, and he delicately provides an answer that is rooted in the personal destinies of his characters.

Ultimately, Murphy glides the reader to a gentle landing spot. After all the fury of AIDS activism, broken families and lifelong resentments, the flawed and sometimes flailing characters of Christodora are provided with a lovely parting gift. To all of this rancor, Murphy calls a kind of merciful truce.

The final notes of charity in Christodora are all the more bittersweet given they were written by an HIV journalist who, one suspects, longs for moments of healing grace every bit as wistfully as we do.

Mark

(Christodora would make an ideal gift to yourself for this World AIDS Day, or a great Kindle stuffer for someone you love – or for someone who could use a better understanding of the impact of these last thirty years. Check it out on Amazon here.)

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Posted in Book Review, Gay Life, Living with HIV/AIDS, Meth and Recovery, My Fabulous Disease, News | No Comments »

Sleeping with President Donald Trump

Tuesday, November 15th, 2016

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I am on my feet at the Thanksgiving table, and my fists are slamming into the linen napkins. Silverware is quaking, pottery is rattling. The force of a particularly hard blow to the tabletop sends a dinner roll catapulting from the bread basket.

My screams are borrowed from post-election protest marches. They are deafening and unending. Fight him. Reject hate. Protect ourselves.

Surrounding the table are members of my family, some red and some blue. They pay me no attention. They are chatting among themselves, unaware of my thunderous cries. Forks and spoons and now falling to the floor and cartwheeling away. A bowl of green bean casserole has rumbled to the edge of the table and any second now it will

I wake up. It is morning in America.

While eating my breakfast cereal I luxuriate in thoughts of assassination. Oh my God that’s awful, my husband tells me, don’t even think such a thing. So I search for it online. I enter the letters “T-r-u-m-p A-s-s” and my browser helpfully fills in the rest. Nobody told my laptop it can’t think that way. My dreadful topic is the first suggestion Google offers.

Hello, NSA. You must be very busy. I’m just a depressed liberal. Move along, nothing to see here.

HIV activists have fought presidents before. We protested while carrying urns filled with ashes. We had motivation and grief and outrage. We believed we could change the world and we did. We actually did.

I was a young man then. I have been glancing at those years in the rearview mirror ever since. I write about them often. It hadn’t occurred to me that we could face that level of ignorance and danger again in my lifetime. And trust me on this, the policies and positions of our new administration, on everything from LGBT rights to HIV education, will have a direct impact on the number of urns to be filled in years to come.

The past may be prologue, but that analogy doesn’t satisfy me. Our past is a monster we had beaten down. But then it faded behind us, beyond reach, and somewhere back there it grew strong and fearsome and has now leapt over us to become our immediate future.

My horror imagery comes from my dreams. I work hard not to think of these things, at least during my waking hours. I’ve turned away from television news, angrily, like a lover who bitterly betrayed me. But at night it can’t be helped.

Our new president is smirking at his inauguration. He is waving to all of those he has so cynically duped, and surrounding him are white men sneering so broadly they look reptilian. Our outgoing president and his wife are enduring the event bravely, but their very presence among this grotesquerie is so out of time their image might as well be a weathered tintype.

I wake up. It is another morning in America, and I struggle to decide whether or not to surrender myself to sleep again. I honestly cannot decipher the better of the two.

Mark

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Posted in Family and Friends, Gay Life, Living with HIV/AIDS, My Fabulous Disease, News, Prevention and Policy, Trump | 5 Comments »

Video: Aboard the 2016 HIV Cruise Retreat

Friday, November 11th, 2016

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The spirit of the annual HIV Cruise Retreat (also known as “the Poz Cruise” but not associated with POZ Magazine) can be summed up in one enlightening story.

Matthew had some bad luck as he boarded the ship for our 8-day tour of the Caribbean. His luggage didn’t make it. He literally had his carry-on bag (which included his meds, thank goodness) and the clothes on his back.

At the opening reception for our 250 cruisers, we made an announcement about Matthew’s plight. Instantly, clothing was crowd-sourced for Matthew, including everything from formal attire to swimsuits. Each night at dinner Matthew appeared in some new outfit pieced together from various contributions.

“Matthew,” I would ask him each day, in my best Joan Rivers voice, “I love your outfit. Who are you wearing?”

“Everyone,” he would reply with a sunny smile.

The HIV Cruise Retreat brought together people living with HIV and our loved ones (four different men brought their mothers) for fellowship and joy. It includes both men and women, gay and straight, with men very much in the majority. (Although, as you will see in the cruise video, that by no means suggests the straight passengers are bashful wallflowers. Their costume party appearance produced so many gasps that I do believe the ship shuddered a little.)

I am fully aware that the cruise, with prices beginning in the $650 range, is out of reach for many people living with HIV. As a volunteer host, it is something that I must save for every year. But I support anything that builds important community among people with HIV, and that includes vacations that have real value beyond the perks and the destinations.

For more information on the 2017 cruise, visit the cruise website or contact our fearless leader, Paul Stalbaum, at 954-566-3377 or via email at paul@cruisedesignstravel.com.

Enjoy the video, and please be well.

Mark

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Posted in Family and Friends, Gay Life, Living with HIV/AIDS, My Fabulous Disease, News | 1 Comment »

My Gay Love for Monster Movies

Monday, October 24th, 2016

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My first boyhood crush was on a dead man. He was a zombie named Quentin Collins, with eyes that pierced my pubescent gay soul and sideburns the size of the Florida peninsula. He stalked across my TV screen on weekday afternoons at precisely 3:30, when the series “Dark Shadows” introduced me to all manner of vampires, werewolves and ghouls in the early 1970’s.

Quentin was dreamy (literally, since he spent a lot of time staring into space in a zombie trance), and had a lonesome, lost quality I recognized but couldn’t yet identify. I saved allowance money for the soundtrack album and replaced the David Cassidy poster in my bedroom for one of Barnabas Collins, the series’ vampire star.

Before long, I graduated to horror films. Slashers did the trick for a while because I delighted in those oversexed straight couples getting whacked with such regularity. If my burgeoning sexuality dared not speak its name, it was enormously satisfying, at least, that straight love was so damn hazardous.

But it was never the killing itself that attracted me. It was the mysterious, gruesome, self-loathing monster. Here I was, in the midst of full pubescent hormonal freak out, with a body revolting against me and a mind wracked with heretical carnal desires. I didn’t just sympathize with the Alien and Pinhead and Freddy, I wanted to take them to lunch and find out how they managed to make it through the day.

My taste for cinematic horror took a break in the 1980’s, during the worst of the AIDS crisis. Something about watching Re-Animator on VHS while my friend Lesley lay dying in the guest room severely reduced the fun factor. AIDS had become the monster, and my sympathies were spent. For at least ten dreary years I stuck to romantic comedies.

If the state of my personal AIDS crisis can be measured in movie genres, then my trauma must have subsided because horror movies are back in my Netflix queue with a vengeance. I’ve been popcorn-munching to zombies, toolbox killers and possessed toys and loving every minute. I can’t even manage to remove the fabulously dreadful Clash of the Titans remake from my watch list.

Ah, Greek mythology monster movies. It is impossible to resist the sight of Liam Neeson as Zeus, growling with magnificence as he commands, “Release the Kraken!” No three cinematic words since “you complete me” have so enraptured my senses, and they are worth the wait. That Kraken is bitchin’.

You should have seen the stir I created at the 1977 Junior Homecoming when I arrived, the school’s weird gay creature, wearing leather platform boots that reached to my knees. I relished in horrifying the crowd and seeing the jaws drop and the fingers pointing at the beast. No Kraken could have cleared the dance floor as fast as my solo disco moment, just before being chased to my car.

It’s hard running in platform boots. I could have used Pinhead for backup.

Mark

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Posted in Gay Life, Living with HIV/AIDS, My Fabulous Disease | No Comments »

The CDC’s Gay Dance Video about HIV is Flat Out Fabulous

Tuesday, September 27th, 2016

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The dance club depicted in the CDC music video for “Collect My Love” (full video below). Condoms, PrEP, and being HIV positive and undetectable all get screen time.

The Centers for Disease Control and Prevention (CDC) has produced a music video that joyfully educates gay men about HIV prevention options. And it is foot-stomping fabulous.

The song, “Collect My Love,” was released by The Knocks and it features vocals by Alex Newell, the young gender-bending singer who rose to fame by stealing season three of the television series, Glee (his rendition of “Boogie Shoes” on that show is a one-way ticket to my happy place).

In the CDC music video released today, Newell performs the song in a crowded, gay-friendly dance club. The atmosphere is ebullient and cruisy, with gay men making connections left and right. That’s where HIV prevention comes in.

Gay couples meeting at the club are shown later, as their relationships develop. There is a condom negotiation, a man shown taking PrEP, and even a character who discloses he is HIV positive and undetectable. The CDC has filled the video with every prevention method available, and they do it in a sex-positive, non-judgmental atmosphere. The video was created as part of the “Start Talking. Stop HIV.” campaign that reaches out to men who have sex with men (MSM), particularly African-American and Latino gay men.

In an exclusive interview with Alberto Santana of the CDC’s Division of HIV/AIDS Prevention and Manny Rodriguez, part of the creative team at agency FHI360, both men made clear that solid research was their guide.

“This is an authentic campaign,” said Rodriguez, “with gay men involved in both the campaign staff and creative team. Our goal was to marry CDC research with something that is accessible and enjoyable to watch.”

“We know that having conversations about HIV can increase good health outcomes and strengthen relationships,” said Santana. “We also wanted to playfully connect to pop culture. We are putting out important information, and doing it outside the normal means.”

The CDC is exceedingly careful to provide scientifically accurate messages, but has certainly never delivered these messages in such an innovative and entertaining way. The video incorporates both PrEP and the fact people with HIV can become undetectable — two important and often misunderstood issues being heavily discussed among the gay community right this minute.

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In this behind-the-scenes shot, the crew films actors playing a new couple from the nightclub who take a home HIV test together.

The men featured in the video are youthful and attractive, but blessedly, they look like young men you might actually meet in a club, not unattainable icons from the pages of Men’s Fitness. In fact, there’s a plus-sized bear seen tearing up the dance floor who walks away with the video during his few seconds on camera. In my mind’s eye, that jubilant, self-possessed man is not going home alone.

Sure, the world conjured in the CDC video may not reflect all interactions among gay men as we know them to be. Stigma and judgment still exist and are practiced nightly in clubs throughout the country. But I wholeheartedly support this alternative, aspirational world, where gay men live joyfully and play responsibly. That’s the world I want to live in.

The video will be shared on social media and through CDC’s community partners. But why wait? Check it out, and share it with your networks. Discuss it. Start a conversation about the ways we can protect ourselves and our community.

And put on your dancing shoes.

Mark

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Posted in Gay Life, Living with HIV/AIDS, My Fabulous Disease, News, Prevention and Policy | 4 Comments »

My Attitude Adjustment About Sex, Gonorrhea, and Advocacy

Thursday, September 22nd, 2016

Concentrated young man with his head melting in tangled lines

Amidst the happy haze of good news about the efficacy of PrEP in preventing new HIV infections and the growing consensus that people living with HIV who are undetectable are not infectious, there is troubling news from the CDC in two new reports about the golden oldies of sexually transmitted infections (STI’s): rates of syphilis are on the rise and antibiotics to treat gonorrhea may be nearing the end of their usefulness.

The news underscores a simmering tension between those of us who celebrate the lowered risk of HIV infection – and the diminishing role condoms might play in HIV prevention during this new era of PrEP and being undetectable – and the rise in reported cases of syphilis and gonorrhea. And I don’t mind being the first to call myself out.

RETHINKING MY GONORRHEA NOSTALGIA

In my cheeky post from last year, “My Gonorrhea Nostalgia,” I argued that what was once a simple rite of passage for many gay men – finding yourself at a clinic with the clap – has been judged and scorned so harshly these days that it has “raised the bar” on what we consider to be acceptable gay sexual behavior. From that piece:

When did avoiding every possible STI become the new goal for gay sexual behavior? Syphilis, chlamydia, and gonorrhea are all easily treated and cured. Scary campfire tales of a spreading superbug impervious to all treatment have failed to materialize. The very idea of getting The Clap again just makes me feel nostalgic.

No longer is avoiding HIV the prime objective; we must also now use a condom every time so that we are never exposed to, well, whatever. How many hoops must we jump through in order to fuck in a pleasurable way? We can’t win for losing.

While I stand by the basic tenants of my rant – gay men are held to a higher standard because we are viewed as sexual outlaws – new data runs counter to my assertion that STI’s are “easily treated and cured.”

HAZARDS AHEAD?

“If current trends continue, strains of gonorrhea could become resistant to all available antibiotics, putting the 800,000 Americans who contract the sexually transmitted infection (STI) annually at risk of an untreatable case,” writes Ben Ryan for POZ, citing a new CDC report. He goes on to explain that at least one cluster of gonorrhea cases has begun to evade our current treatment arsenal and that’s why the CDC is sounding the alarm about it.

While gonorrhea remains universally treatable, there is evidence of a weakening of current treatments, and there are no other approved medications in the wings. Should untreatable strains begin to circulate, we may soon find ourselves without an effective solution, although a new drug in clinical trials is showing some promise.

Meanwhile, yet another new CDC report, this one charting syphilis cases by State, reinforces data that syphilis cases have spiked 15%. In the State-by-State comparison, a CDC graph shows the largest increases are mostly located – you guessed it – in the South (congrats on your win, North Carolina, although your victory is a hollow one since Georgia, the perennial favorite State for syphilis, is not included for lack of reporting data). The data also indicates an increase in syphilis diagnosis among gay men that has persisted since the year 2000.

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It isn’t clear from the CDC report whether an increase in syphilis screening might account for the increase in reported syphilis cases. But still. “Although we have been treating syphilis effectively with penicillin for decades,” said CDC epidemiologist Cyprian Wejnert, the presenter of the screening data, “the risks of not being treated include visual impairment, damage to the nervous system, and stroke.”

TWO HIV ADVOCACY CAMPS OFTEN AT ODDS

And herein lies the tension. There are two distinct schools of thought on modern gay sexual politics and HIV, and too often they are loathe to overlap.

First, there are those, like me, who are thrilled that after a generation of mortal fear there are now ways for us to have pleasurable sex without condoms that does not pose a risk of HIV infection. It is just that sense of liberation that has propelled much of my writing, such as “Your Mother Liked It Bareback,” and it has led to a welcome increase in conversations about the value of sexual pleasure.

And then, there are those who have been more cautious, pointing out the risk of STI’s in general and among those using PrEP in particular. This has led to some acrimony. POZ science writer Ben Ryan, who has written quite a lot about PrEP, was blocked from the highly influential “PrEP Facts” Facebook page earlier this year for not adhering to group guidelines. Ryan had previously posted numerous articles that have taken a more circumspect view of PrEP or have reported on the prevalence of STI’s, and his work continues to be posted and discussed in the group.

The new CDC articles on gonorrhea and syphilis do not correlate the increase in STI’s to those using PrEP or to those who may have eschewed condoms because they are HIV undetectable. But that doesn’t mean that people on both sides of a widening chasm between the cautious and the sex-positive won’t try to score points from the CDC report or attempt to dissect its accuracy. Advocates trying to adhere to a singular message can be touchy. Been there, wrote that.

As for me, I’ll switch to the combination platter, thanks. While I will continue to celebrate the breakthroughs that have given us more options to “fuck without fear,” as the notable and quotable PrEP advocate Damon Jacobs likes to say, I’m going to dial back my cavalier posture about the risk of being infected with an STI. In light of mounting data on STI’s, some of my own past writing makes me cringe.

The only constant in the world of HIV is change. I remember when taking an HIV test was politically incorrect, when I took AZT every four hours and, more recently, when I believed a simple case of gonorrhea was worthy of clever mirth. I’ve had an attitude adjustment.

While catching the clap might have once been an amusing rite of passage to me, it can have real and very serious consequences for someone else.

Mark

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What It Feels Like for a Mom

Tuesday, September 13th, 2016

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(My mother, Anne King, turns 90 this month. This story is my tribute, and you can hear her story in her own words in the video below.)

I was standing at the ticket counter of the movie theater and couldn’t believe my ears. They were telling me that Theater of Blood, with the great Vincent Price, was rated “R” and they were not letting me in without a parent. I was a horror-movie obsessed boy of 12, and was inconsolable. “I won’t look at any sexy stuff,” I remember pleading, “I just came for the gore!”

MomWith visions of decapitations fading like an old blood stain, I made the long walk back home and exposed my broken heart to Mother, who made one of the grandest gestures of my childhood: she took me back for the late show. On a school night.

It wouldn’t be the last time she had my back. Over the years she has proved herself a trustworthy ally, and this was never more true than in the 1980’s, when gay men often lost their mothers — hell, their entire families — when an AIDS diagnosis was revealed.

Mom never abandoned me or my gay older brother, Dick (is there no gayer name than Dick King? Did my parents consult the Falcon Video Book of Baby Names?). I tested positive in 1985, and Mom immediately went to work educating herself on HIV.

My brother was spared HIV infection but suffered its cruelty nevertheless: his lover of 13 years, Emil, died of AIDS in the early, scorched-earth years of the epidemic.

In this video from 2010, I sat Mom down to find out things I’ve never asked before. What did she really feel when she found out I was positive? Did she believe I would die? Do mothers have a right to know? What advice would she offer other families? We also talk about the loss of Emil and the repercussions from it we still feel today.

(If your browser has issues with the video below, you can watch it on YouTube here.)

Mom is no expert. She isn’t an AIDS researcher and she doesn’t march on Washington. She just loves her kids and tries to understand what is happening in their lives and how she can help. If your mother is like mine, we have a lot to celebrate (or remember) this Mother’s Day weekend.

Enjoy the video, and please, stay well.

Mark

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LEAKED: Five Point Internal Memo to Chase Brexton CEO!

Monday, August 22nd, 2016

Richard Larison Amy Davis Baltimore Sun

Richard L. Larison, Chase Brexton CEO (photo: Amy Davis / Baltimore Sun)

TO:         Richard Larison, CEO, Chase Brexton

FROM:     Your Executive Assistant

RE:         Five points about the recent unpleasantness

Sir,

I know you’ve asked me not to disturb you when you are sealed in your hyperbaric chamber. Regrettably, it has been days since you have emerged and there are developments. (Note to self: throw something over Mr. Larison’s glass tomb before leaving office; the housekeeping staff is complaining again; use some of those stored AIDS Quilt panels Mr. Larison found “needlessly depressing.”)

Your termination of the five managers here at Chase Brexton appears to have had an unintended effect. Rather than frighten the indentured ungrateful uppity low-level employees into rejecting their own unionizing effort, the firings appear to have emboldened them. It would appear they do, in fact, have minds of their own. And this, only days before their vote to unionize on August 25th.

At the risk of upsetting you again (I have replaced your shattered “World’s Greatest Boss” coffee mug and cleaned the stains; my injuries were minor), allow me to enumerate five key developments of the last week.

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The Chase Brexton protest drew more than 100 protesters and speakers. (Photo: Baltimore Sun)

1. A protest was held Friday. They don’t like us.

Since I don’t believe you can hear from within your sealed chamber (and if so, I swear to you that the existential cries of “why me?” and “what cruel hell is this?” were not coming from my cubicle), allow me to share the unsettling news that the protest against our union-busting efforts was spirited and well attended. It also included many members of the gay, lesbian, and transgender community for whom this agency was founded, which explains why no one in the executive offices has any idea who they are.

The media has caught wind of all this, I regret to say. Lots of stories that present our actions accurately in unfavorable light, including an Op-Ed in the Baltimore Sun by two of our own medical physicians (the doctors actually spill the beans on our efforts to limit doctor-patient time and cut salaries). A #SaveChaseBrexton web page with photo and videos exists, and the protestors and speakers look, well, empowered, although I know how you despise that word.

 

2. It appears we are screwing with the wrong people.

It was reasonable to expect that the recent terminations would be as uneventful as the past (two hundred? three?) firings during your four-year reign occupation tenure (I have prepared your weekly “Chopping Block” list; we can go alphabetically, pick someone at random, or I believe you enjoyed tossing darts at names). However, these recent firings appear to have galvanized employees, volunteers, and clinic patients alike.

The protest was attended by several elected officials, such as Maryland delegate Cheryl Glenn, who delivered a rousing indictment of our union-busting efforts. She also ended with a song that sounded communist to me; I can plant social media comments to that effect if you think it would be helpful.

Marty Jon

News stories associated with the union-busting consultants used by Chase Brexton.

3. Those union-busting advisors we hired might be actual criminals.

Yes, I know the three of you bonded over your shared love of hunting endangered species, but I have misgivings. It would appear that the two gentlemen who conducted our intimidation misinformation educational session about unions for employees, Martin Dreiss and Jon J. Burress, have faced charges between them ranging from fraud and conspiracy to embezzlement. I understand you find this endearing, sir, but we might consider avoiding these “union avoidance” fellows in the future. We have our own foggy legalities to negotiate, such as…

jill crank fake letter

Actual letter sent to patients of fired employee Jill Crank.

4. They found out we faked that letter to the patients of the nurse you fired.

You know that letter we sent to the patients of infidel sacrificial lamb nurse practitioner Jill Crank, making it look like she left all by herself and we totally, absolutely had nothing to do with it? Turns out people actually read the damn thing. They quickly deciphered the fact it wasn’t she who sent it, probably due to the multiple spelling and grammatical errors.

We’re not completely certain that faking a letter from Ms. Crank without her consent is precisely legal, but that ethical ship has sailed, I think you will agree.

Speaking of which, sir, may I add how delightful it is to conduct ourselves so freely, unmoored from complex concepts such as integrity or loyalty to Chase Brexton’s community legacy! This is all a direct result of your terrifying brave leadership, Mr. Larison.

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Email to staff from Board President Carolyn Kennedy, announcing new committee and efforts to “rebuild trust,” none of which reinstates fired employees.

5. Our new committee to “rebuild trust” has people laughing. A great deal.

Regrettably, the new President of Operations position you announced carries the moniker of POO, which is a fair assessment of the resume of this new hire, if we’re being honest. As vexing as you find the need for relevant experience, it appears that Mr. Joseph Lavelle, hired to smooth over staff conflict, has no LGBT-focused background, has no experience in a community-based clinical setting, and worked for gargantuan medical conglomerates that got sued a lot. But that’s not the funny part.

If you venture beyond your nesting place office, you may hear giggling coming from “the minimals,” as you call them. It seems that the staff email from Board Chair Carolyn Kennedy announcing the formation of an ad-hoc committee has been met with derision, if not sustained guffaws. The phrase “rebuild your trust” appears to be the big punch line. One might even say we are closing the barn door after the unfair labor practices horses have left, but I know you find popular expressions that do not end with “therefore improving our bottom line” to be most disagreeable.

Lastly, much of the attention now appears to be focused on removing you as CEO. Should this abomination occur, rest assured I will follow you, hyperbaric chamber in tow. You frighten me, yes, and you have single-handedly crippled our reputation throughout Baltimore, but my personal value system is so damaged I am actually willing to trust your stewardship despite all evidence to the contrary.

Which, come to think of it, would make me an excellent member of the Board.

Fearfully, endlessly,

Your Executive Assistant

(In the latest non-satiric news: Victory (for now)! The first group of Chase Brexton employees eligible to join the union voted on August 25 IN FAVOR of joining SEIU1199. And get this: the margin was 87 to 9. Moire than ever, it appears the tactics of management have backfired. Management will almost certainly attempt to contest the results, and this struggle may drag on, continuing to destroy the reputation of Chase Brexton. For the moment, employees have real reason to celebrate. They are unified. — Mark)

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